Surgical Care and Outcomes Assessment Program Comparative Effectiveness Research

Summary

Principal Investigator: DAVID R contact FLUM
Abstract: DESCRIPTION (provided by applicant): The Surgical Care and Outcomes Assessment Program (SCOAP) is a voluntary, performance surveillance, sharing and feedback platform derived from clinical records. SCOAP improves quality by increasing adoption of evidence-based process of care measures and performing "real world" comparative effectiveness research (CER). In just four years, SCOAP was deployed across nearly all statewide hospitals. Versions of SCOAP exist for cardiac care, general surgical care, pediatric surgical care, and now vascular interventions (VI- SCOAP) for peripheral vascular disease. As a platform for both CER and improved adoption of CER-informed process of care measures for clinical quality improvement (QI), SCOAP is currently limited in scale by a lack of automated data gathering, linkage between data streams and connections to post-discharge and patient reported outcomes. Drawing information out of these different systems and linking them to other data sources for CER or QI requires an information technology solution that can interact with all available data systems and all types of data. We propose to deploy Amalga UIS" across the SCOAP Network to address the problem of inter-system connectivity by linking data systems in a common, framework. Amalga UIS" deployment within SCOAP will create automated data retrieval from each participating hospitals'varied electronic sources, doctor's offices and outpatient data streams. We will link automated clinical data with to administrative claims to track for all subsequent hospitalizations, vital status records for survival outcomes, healthcare payer claims datasets for outpatient encounters and medication utilization data, and point-of-care, longitudinal patient reported outcomes. The resulting SCOAP CER Translation Network (CERTN) will facilitate efficient CER as well as support SCOAP's QI initiatives around CER-driven process of care metrics. We will demonstrate the usability of the SCOAP CERTN Project for research and improved adoption of CER-informed process of care by using VI-SCOAP and comparing the treatment strategies of peripheral arterial disease and addressing procedural safety. Leveraging existing strengths of the SCOAP network and the VI-SCOAP registry with Microsoft's partnership, we propose several enhancements to improve our capability and scalability for longitudinal clinical and patient reported outcomes data collection. The SCOAP CERTN project will be a large-scale, real-world resource for CER based on clinical data using an automated data retrieval stream from diverse healthcare settings. This will greatly enhance existing SCOAP QI by delivering more comprehensive and timely data, and in relieving manual staff and resource burden to participating hospitals. SCOAP CERTN's initial CER focus will be in vascular surgery and interventions, but the project will be a gateway for investigators from all clinical disciplines to evaluate clinical outcomes, cost-impact, PROs and to translate evidence into QI. Importantly, surgical and interventional services span the continuum of healthcare conditions and SCOAP CERTN will have immediate capacity for investigators interested in almost any of AHRQ's priority conditions. PUBLIC HEALTH RELEVANCE: The SCOAP CERTN project will be a large-scale, real-world resource for CER based on clinical data using an automated data retrieval stream from diverse healthcare settings. SCOAP CERTN project's initial focus will be in vascular surgery and interventions, but this will be a gateway for investigators from across all clinical disciplines to evaluate clinical outcomes, cost-impact, patient reported outcomes and to translate evidence into clinical quality improvement. Surgical and interventional services span the continuum of healthcare conditions and SCOAP CERTN will have immediate capacity for investigators interested in almost any of AHRQ's priority conditions.
Funding Period: ----------------2010 - ---------------2013-
more information: NIH RePORT

Top Publications

  1. pmc A survey of informatics platforms that enable distributed comparative effectiveness research using multi-institutional heterogenous clinical data
    Dean F Sittig
    School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, USA
    Med Care 50:S49-59. 2012
  2. pmc Importance of perioperative glycemic control in general surgery: a report from the Surgical Care and Outcomes Assessment Program
    Steve Kwon
    Department of Surgery, University of Washington, Seattle, WA, USA
    Ann Surg 257:8-14. 2013
  3. pmc A model for incorporating patient and stakeholder voices in a learning health care network: Washington State's Comparative Effectiveness Research Translation Network
    Emily Beth Devine
    Pharmaceutical Outcome Research and Policy Program, University of Washington, Seattle, WA, USA
    J Clin Epidemiol 66:S122-9. 2013
  4. ncbi Comparative effectiveness of skin antiseptic agents in reducing surgical site infections: a report from the Washington State Surgical Care and Outcomes Assessment Program
    Timo W Hakkarainen
    Department of Surgery, University of Washington Medical Center, Seattle, WA Electronic address
    J Am Coll Surg 218:336-44. 2014
  5. ncbi Implementation of a "real-world" learning health care system: Washington State's Comparative Effectiveness Research Translation Network (CERTAIN)
    David R Flum
    University of Washington, Seattle, WA Electronic address
    Surgery 155:860-6. 2014
  6. pmc Creating a learning healthcare system in surgery: Washington State's Surgical Care and Outcomes Assessment Program (SCOAP) at 5 years
    Steve Kwon
    Department of Surgery and the Surgical Outcomes Research Center, University of Washington, Seattle, WA 98195 6410, USA
    Surgery 151:146-52. 2012
  7. pmc β-blocker continuation after noncardiac surgery: a report from the surgical care and outcomes assessment program
    Steve Kwon
    Department of Surgery and Surgical Outcomes Research Center, University of Washington, Seattle, WA 98195 6410, USA
    Arch Surg 147:467-73. 2012
  8. pmc Routine leak testing in colorectal surgery in the Surgical Care and Outcomes Assessment Program
    Steve Kwon
    University of Washington, Department of Surgery and Surgical Outcomes Research Center, Seattle, WA 98195, USA
    Arch Surg 147:345-51. 2012
  9. pmc Adoption of laparoscopy for elective colorectal resection: a report from the Surgical Care and Outcomes Assessment Program
    Steve Kwon
    Department of Surgery, University of Washington, Seattle, WA 98195 6410, USA
    J Am Coll Surg 214:909-18.e1. 2012

Detail Information

Publications9

  1. pmc A survey of informatics platforms that enable distributed comparative effectiveness research using multi-institutional heterogenous clinical data
    Dean F Sittig
    School of Biomedical Informatics, University of Texas Health Science Center, Houston, TX, USA
    Med Care 50:S49-59. 2012
    ..We expect that over the next several years these projects will provide answers to many important, and heretofore unanswerable, clinical research questions...
  2. pmc Importance of perioperative glycemic control in general surgery: a report from the Surgical Care and Outcomes Assessment Program
    Steve Kwon
    Department of Surgery, University of Washington, Seattle, WA, USA
    Ann Surg 257:8-14. 2013
    ..To determine the relationship of perioperative hyperglycemia and insulin administration on outcomes in elective colon/rectal and bariatric operations...
  3. pmc A model for incorporating patient and stakeholder voices in a learning health care network: Washington State's Comparative Effectiveness Research Translation Network
    Emily Beth Devine
    Pharmaceutical Outcome Research and Policy Program, University of Washington, Seattle, WA, USA
    J Clin Epidemiol 66:S122-9. 2013
    ....
  4. ncbi Comparative effectiveness of skin antiseptic agents in reducing surgical site infections: a report from the Washington State Surgical Care and Outcomes Assessment Program
    Timo W Hakkarainen
    Department of Surgery, University of Washington Medical Center, Seattle, WA Electronic address
    J Am Coll Surg 218:336-44. 2014
    ..Surgical studies to date have had contradictory results. We aimed to further evaluate the relationship of commonly used antiseptic agents and SSI, and to determine if isopropyl alcohol has a unique effect...
  5. ncbi Implementation of a "real-world" learning health care system: Washington State's Comparative Effectiveness Research Translation Network (CERTAIN)
    David R Flum
    University of Washington, Seattle, WA Electronic address
    Surgery 155:860-6. 2014
    ..Most examples of learning systems derive from integrated care delivery systems and examples of such systems in the community at large have been lacking...
  6. pmc Creating a learning healthcare system in surgery: Washington State's Surgical Care and Outcomes Assessment Program (SCOAP) at 5 years
    Steve Kwon
    Department of Surgery and the Surgical Outcomes Research Center, University of Washington, Seattle, WA 98195 6410, USA
    Surgery 151:146-52. 2012
    ..We provide, here, the progress of the SCOAP initiative and highlight its achievements and challenges...
  7. pmc β-blocker continuation after noncardiac surgery: a report from the surgical care and outcomes assessment program
    Steve Kwon
    Department of Surgery and Surgical Outcomes Research Center, University of Washington, Seattle, WA 98195 6410, USA
    Arch Surg 147:467-73. 2012
    ..Despite limited evidence of effect, β-blocker continuation has become a national quality improvement metric...
  8. pmc Routine leak testing in colorectal surgery in the Surgical Care and Outcomes Assessment Program
    Steve Kwon
    University of Washington, Department of Surgery and Surgical Outcomes Research Center, Seattle, WA 98195, USA
    Arch Surg 147:345-51. 2012
    ....
  9. pmc Adoption of laparoscopy for elective colorectal resection: a report from the Surgical Care and Outcomes Assessment Program
    Steve Kwon
    Department of Surgery, University of Washington, Seattle, WA 98195 6410, USA
    J Am Coll Surg 214:909-18.e1. 2012
    ..The purpose of this study was to evaluate the adoption of laparoscopic colon surgery and assess its impact in the community at large...